The latest issue of the Health-EU Newsletter spotlights Complementary and Alternative Medicine (CAM). CAM is becoming increasingly popular in Europe, with up to 65% of the population reporting that they have used this form of medicine. The main reasons given for using CAM are its holistic approach, effectiveness and orientation towards promoting health rather than controlling symptoms. CAM therapies commonly approach health and illness by working to induce and support the innate self-healing process of the individual. They are used to promote and maintain health and can be used as a first option in a wide range of health problems, particularly where conventional therapies do not exist or are ineffective, but also as a complement to conventional treatment.

The newsletter highlights EUROCAM, the alliance of patients, doctors and practitioners in the field of CAM, which is committed to raising public awareness of the public-health benefits of CAM, especially in terms of prevention and health promotion, patient safety, patient-centred health services, mental health, palliative care, health economics and healthy ageing.

Responding to increasing use of CAM by the European public, the European Commission's Directorate-General for Research has funded CAMbrella, a project to develop a roadmap for future European research in CAM that is appropriate for Europe's health care needs.

The Health-EU Newsletter provides twice a month a selection of the latest news and activities in the field of public health at both European and international level in 22 of the EU’s official languages. The newsletter complements the information on the Health-EU Portal, the Public Health Portal of the European Union. The Portal aims to provide European Citizens with an easy access to reliable, multilingual and comprehensive information on Public Health initiatives and programmes at EU level. The Portal is directed at those who want to keep informed about issues affecting their health, and at those who wish to keep up to date with policies and decisions taken at European, national and international level. The Portal is also an important source of information for health professionals, administrations, policy makers and stakeholders. It is accessible to everyone, including older people and people with disabilities, as it follows the internationally recognised rules on accessibility. The Portal also provides expert users with access to statistical databases relevant to public health.

Researchers from the Bhabha Atomic Research Centre, Mumbai, India have recently used a Medical Analyzer System to explore the autonomic response of selective homeopathic medicines in healthy persons. The objective of this investigation was to observe the changes produced in the spectrum of heart rate variability and blood flow variability following administration of placebo and different potencies of certain homeopathic medicines

This investigation is particularly interesting because, even though several clinical studies have demonstrated an effect of highly diluted homeopathic medicines, until now their action had not been directly observable.

In the Indian research study the effect of different homeopathic potencies of Aconitum napellus, Arsenicum album, Gelsemium sempervirens, Phosphorus, Pulsatilla nigricans, and Sulphur on heart rate variability and blood flow variability were recorded in 77 subjects within an age range of 18-35. The results show a range of responses that are varied and interesting e.g. a pattern seems to emerge from these experiments that medium potencies such as 30c and 200c have probable action on heart rate variability and higher potencies such as 1M have probable action on blood flow variability. However, the authors state this is an exploratory study and that ‘These are observations from exploratory experiments in emerging areas of physiologic variability and need validation by repeated experiments of this type. Detection of response was the primary objective of this study, which has been achieved. The number of subjects in each group was small; hence it was not possible to show the statistical significance of the results, an aspect that will be covered in future studies.’

With the use of the medical analyzer, the researchers may have found a way to move research in the area of ultramolecular homeopathic preparations forward. Their research study suggests that it is possible to record the response of homeopathic medicines on physiologic parameters of the autonomic nervous system, thus offering a means of measuring a direct physiologic effect in an objective, rather than subjective, manner.

A team of researchers at the Indian Institute of Technology (IIT), Bombay, have demonstrated the presence of physical entities in extremely high homeopathic dilutions, in the form of nanoparticles of the starting materials and their aggregates.

Homeopathy is controversial because medicines in high potencies such as 30c and 200c involve huge dilution factors which are many orders of magnitude greater than Avogadro’s number, so that theoretically there should be no measurable remnants of the starting materials. No hypothesis which predicts the retention of properties of starting materials has been proposed nor has any physical entity been shown to exist in these high potency medicines.

Using market samples of metal-derived medicines from reputable manufacturers, the researchers have demonstrated for the first time by Transmission Electron Microscopy (TEM), electron diffraction and chemical analysis by Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES), the presence of physical entities in these extreme dilutions, in the form of nanoparticles of the starting metals and their aggregates.

The confirmed presence of nanoparticles challenges current thinking about the role of dilution in homeopathic medicines. Concrete evidence of the presence of particles as found by this team could help take the research in homeopathy a step forward in understanding these potentised medicines and also help to positively change the perception of the scientific community towards this mode of treatment.

The medical practice of homeopathy, Traditional Chinese Medicine, anthroposophic medicine, herbal medicine and neural therapy, which was previously struck off the state insurance list, will be reimbursable from 2012 as part of a six-year trial period.

Back in 2005 the government rejected these complementary (CAM) therapies, arguing they failed to meet the legal requirement of scientific evidence of the three criteria of efficacy, cost-effectiveness and suitability. These three criteria to accept a therapy in the list for reimbursement, are required by the law.

The reversal in policy follows a nationwide vote in 2009 in which two-thirds of Swiss backed expanding the Swiss Federal constitution by an article stipulating that the Federal government and cantons shall ensure that, within the scope of their jurisdiction, complementary medicine is taken into consideration.

As far as the cost-effectiveness of these therapies are concerned, data published in an article in the Swiss Medical Journal* show that even though consultations with doctors who have an additional qualification in homeopathy or other complementary therapies are significantly longer than those in conventional medicine - and leading to a higher patient satisfaction - the total costs per patient per year are not higher and the costs per doctor per year are even 29% lower than in conventional medicine.

The economic benefit of these therapies may have been sufficiently demonstrated, but the health authorities are not yet convinced of the efficacy of the complementary therapies. A federal commission in December 2010 even recommended to strike them permanently from the list because of a 'lack of scientific evidence'. Nevertheless the government has given the medical CAM associations some respite. The associations will have to present conclusive evidence for the efficacy of the complementary therapies by 2017, thus leaving them some time to fill in the gaps for those therapies that so far have not, or only partially, managed to fully meet this requirement.

The evidence is then to go before a recognised international institute for an independent scientific assessment. That institute could be the National Center for Complementary and Alternative Medicine in the USA or the National Institute of Clinical Excellence in the UK.

The government’s decision also includes provisions to boost research and training in the field, which would not be counter-productive, even if there is a negative result for the therapies after the trial period.

* the article in the Swiss Medical Journal - Schweizerische Ärztezeitung is available here, in German only.

In a truly remarkable interview published in SCIENCE magazine of 24 December, Professor Luc Montagnier, a French virologist who co-discovered HIV and who won the Nobel Prize in 2008, describes his newest work that has significant implications on homeopathy.

Montagnier, who is also founder and president of the World Foundation for AIDS Research and Prevention, makes the following strong statement for homeopathy and homeopathic doses: "I can't say that homeopathy is right in everything. What I can say now is that the high dilutions are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules."

In a study that was published in 2009, Montagnier demonstrated that some bacterial DNA sequences are able to induce electromagnetic waves, even at high aqueous dilutions up to 10^-18. This study was an important contribution to the growing evidence base in fundamental research with direct relevance to homeopathy.

Montagnier will take on the leadership of a new research institute at Jiaotong University in Shanghai and plans to study the phenomenon of electromagnetic waves produced by DNA in water. His research team will study both the theoretical basis and the possible applications in medicine.

In the interview Montagnier says that he cannot pursue this research in France because he does not have much funding there. Because of French retirement laws, he is no longer allowed to work at a public institute. But there is another reason as well. When he applied for funding from other sources, he was turned down. Montagnier argued that there is a kind of fear around this topic in Europe.

In this context he refers to Dr Jacques Benveniste, a French physician/scientist who conducted research on homeopathic doses. Montagnier regards him as a "modern Galileo." "Benveniste was rejected by everybody, because he was too far ahead. He lost everything, his lab, his money. … I think he was mostly right, but the problem was that his results weren't 100% reproducible." "I am told that some people have reproduced Benveniste's results, but they are afraid to publish it because of the intellectual terror from people who don't understand it."

Is Montagnier worried that his colleagues will think he has drifted into pseudoscience? He replies adamantly: "No, because it's not pseudoscience. It's not quackery. These are real phenomena which deserve further study."